Healthcare Provider Details

I. General information

NPI: 1205312741
Provider Name (Legal Business Name): JANA DENGLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 07/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

660 S EUCLID AVE CAMPUS BOX 8238
SAINT LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-7388
  • Fax:
Mailing address:
  • Phone: 314-747-2611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number2018021870
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: